Welcome Message

An anxious colleague recently came into my office and closed the door. “I think I might have prostate cancer,” he said quietly. After a moment of stunned silence, I asked him about his prostate-specific antigen (PSA) level and whether he had had a biopsy. “I haven’t had a PSA test recently, and I’ve never had a biopsy,” he replied. “What makes you think that you might have prostate cancer?” I asked. “Well,” he said, “my wife and I had sex last night, and she noticed that there was blood in my semen.”

Few things alarm a man and his partner more than seeing bloody ejaculate, a condition called hematospermia, or hemospermia. It conjures fears of cancer or a sexually transmitted disease. While it’s true that hematospermia may indicate prostate cancer or another urologic disease, that’s usually not the case. In many instances, it has no apparent cause. Just as puzzling, the condition can be limited to a single episode or can occur repeatedly over several weeks or months before disappearing completely.

Doctors have been diagnosing hematospermia for centuries — even the Greek physician Hippocrates, who lived from around 460 to 377 B.C., described it. But the true prevalence of the condition remains a mystery. A busy urologist may see several patients a year with hematospermia, but it’s likely that far more cases go unnoticed by a man or his partner during intercourse. And some cases certainly go unreported by men who’d rather not find out what ails them.

Although health care professionals can’t quantify hematospermia’s prevalence, they have been increasingly able to ascribe the condition to a particular cause, thanks to better diagnostic techniques, advances in medical imaging, and some good old-fashioned sleuthing. From there, they can either prescribe medication or another treatment, or offer an anxious patient some much-needed reassurance that the condition will resolve on its own.

Among the culprits…

Historically, doctors linked hematospermia to sexual behavior. As the authors of an article in The Journal of Urology explain, patients were “warned about excessive overindulgence and prolonged sexual abstinence.” And as recently as a decade ago, most cases (up to 70% in some studies) were diagnosed as idiopathic, meaning that they had no obvious cause. The condition, researchers believed, was “benign and self-limited.” But in 2003, thanks to improved imaging techniques, a team of researchers classified only about 15% of cases as idiopathic. The rest of the cases were attributed to dozens of other factors that they grouped into six categories, as follows.

Inflammation and infection

Inflammation of any of the organs, glands, or ducts involved in the production or storage of seminal fluid can lead to hematospermia. These include the seminal vesicles, vas deferens, epididymis, prostate, and urethra (see Figure 1 below). Inflammation can be caused by irritation or trauma; stones or calcified deposits in the prostate, seminal vesicles, bladder, or urethra; and infections with viruses, bacteria, fungi, or parasites. Sexually transmitted diseases, such as herpes, gonorrhea, and chlamydia, have also been implicated in hematospermia.

Some studies have shown that inflammation and infection are the most common causes of hematospermia in younger men (the average age of hematospermia patients is 37) and up to 39% of cases over all.

Figure 1: Anatomy of hematospermia

Inflammation and infection, an obstruction, a tumor, vascular abnormalities, systemic factors, medical procedures, and trauma may cause bleeding that shows up in semen, a condition called hematospermia, or hemospermia. Any of the organs, glands, or ducts shown here may be the source of the bleeding, though the cause and source of the bleeding often can’t be determined. Note that only a portion of the vas deferens, which transports sperm from the epididymis to the seminal vesicles, is shown.

Obstruction

Obstructed ducts, such as the ejaculatory duct, and the formation of cysts in the prostate or seminal vesicles can cause hematospermia. When ducts are blocked, nearby blood vessels can dilate and rupture. An enlarged prostate, also called benign prostatic hyperplasia, pinches the urethra and can lead to hematospermia, too.

Tumors

Benign polyps and malignant tumors of the prostate, testicles, epididymis, and seminal vesicles may cause hematospermia. Men whose sole symptom is hematospermia are more likely to have prostate cancer than men who don’t have blood in their semen, but the chances are slim. A Northwestern University study of 26,126 men who underwent prostate cancer screening proves the point: among all study participants, 6.5% were diagnosed with prostate cancer. Among those who complained of hematospermia, 13.7% were diagnosed with prostate cancer. (For more details, see “Hematospermia and prostate cancer,” below.) Even though the finding is statistically significant, keep in mind that more than 86% of men with hematospermia don’t have prostate cancer. One could argue, too, that these numbers may be elevated because a screening study like this is likely to attract men at greater-than-average risk of prostate cancer.

A review of other scientific articles found 33 tumors in 931 patients with hematospermia, or 3.5%, far fewer than in the Northwestern study. Of the 33 tumors that were identified, 25 were prostate tumors. The other eight tumors were found in the seminal vesicles, testicles, and epididymis.

Hematospermia and prostate cancer

Vascular abnormalities

Blood vessel abnormalities in the seminal vesicles, bladder, prostate, seminal vesicles, and spermatic cord (the vas deferens and its accompanying arteries, veins, nerves, and lymphatic vessels) may be the source of bleeding.

Systemic factors

Several diseases and disorders that affect the whole body have been linked to hematospermia. These include severe hypertension (high blood pressure), a bleeding disorder called hemophilia, leukemia, and chronic liver disease.

Trauma/medical procedures

Most cases of hematospermia are probably caused, unintentionally, by medical procedures. Transrectal ultrasound prostate biopsy (TRUS-PB), which removes bits of prostate tissue to check for cancer, provokes it. The reported incidence of hematospermia following a biopsy varies between 5.1% and 89%. A recent study by Miami researchers pegged the incidence of hematospermia following TRUS-PB at 84%. On average, hematospermia lasted three and a half weeks before resolving on its own. (For more details, see “Hematospermia and TRUS-PB,” below.)

Other medical procedures, including radiation therapy, brachytherapy, transurethral resection of the prostate (for BPH), and vasectomy can bring about hematospermia, as can testicular or perineal trauma, pelvic fracture, injury during sex, and prolonged sexual abstinence.

Admittedly, reading this long list of possible causes may do little to reassure a man with bloody semen. My colleague, for example, now not only worried that he had prostate cancer, but also that he had polyps, cysts, blocked ducts, and tuberculosis, too. But if you experience hematospermia, don’t let your mind run wild. (Remember that most cases can’t be attributed to a particular cause and resolve on their own without treatment.) Instead, schedule an appointment with your doctor or urologist. If a cause can be determined, it can be treated. If no cause can be found, you’ll probably breathe a bit easier.

Detective work

Your doctor or urologist will begin by taking a detailed medical history and asking questions about your symptoms: How and when did you notice blood in your semen? Have you had a single episode of hematospermia, or has the condition been persistent? Have you had any urologic tests or a prostate biopsy recently? Have you traveled to any areas where tuberculosis is common? What medications are you taking? Have you experienced other symptoms, such as fever, unexplained weight loss, urinary problems, or pain? He or she will also ask about sexual activity.

Next, your doctor will conduct a physical exam to rule out various conditions that can cause hematospermia. He or she will take your blood pressure and temperature, feel your abdomen, examine your genitals, and perform a digital rectal exam to feel for hard spots on the prostate gland and for cysts in the seminal vesicles.

In addition, you will have a blood test, urine analysis, and urine culture. If sexually transmitted diseases are suspected, your doctor may test for them. And if there’s a chance that the blood may have come from your partner, your doctor may suggest a condom test: ejaculate is collected in a condom and then examined for blood.

Just as there is little consensus about when, or even whether, a healthy man should have a PSA test, physicians don’t always agree about when or whether patients with hematospermia should have one. Some experts say it’s necessary only in patients over age 50 unless the patient has a family history of prostate cancer. Others, including me, recommend PSA testing in all hematospermia patients over age 40 because, as I noted, it can be a sign of prostate cancer. The incidence of prostate cancer in younger men is quite low — according to the National Cancer Institute, only 0.6% of cases are diagnosed in men age 44 or younger. So, in my opinion, PSA testing before 40 probably isn’t necessary unless you have other symptoms. In an older man with a borderline-high PSA score, I would consider ordering a prostate biopsy.

Men who have persistent hematospermia, blood in the urine, or other symptoms, or who are over age 40 may have a transrectal ultrasound (TRUS) to look for abnormalities in the prostate, seminal vesicles, and other tissues. During this procedure, the doctor inserts an ultrasound probe into the rectum (see Figure 2 below). The probe emits sound waves and then “listens” for echoes as the waves bounce back off surrounding tissues (the prostate, for example).

Figure 2: Transrectal ultrasound

During a transrectal ultrasound, an ultrasound probe is inserted into the rectum. The probe emits sound waves that bounce back off surrounding tissues. Depending on the strength, pitch, and direction of the reflected sound waves, a computer can create pictures of the internal anatomy.

Based on the strength, pitch, and direction of the reflected waves, a computer creates pictures of the internal anatomy (see Figure 3 below). Several studies have shown that TRUS effectively pinpoints usually benign abnormalities that can lead to hematospermia in 74% to 95% of patients. Among the findings: enlarged seminal vesicles; stones in the seminal vesicles, prostate, or ejaculatory duct; cysts; and BPH. Interestingly, no cancers were detected in these studies. Because it is so effective and minimally invasive, TRUS is the first type of imaging that should be performed.

Depending on what information TRUS yields, your doctor may recommend two other procedures: magnetic resonance imaging (MRI) and cystoscopy. Unlike TRUS, MRI can reveal bleeding in the seminal vesicles or prostate. Cystoscopy allows your doctor to examine the inside of the bladder and urethra, areas that may not show up well on MRI and TRUS, with a thin, lighted instrument called a cystoscope.

Figure 3: A transrectal ultrasound image

A trained eye can spot structures such as the prostate, bladder, and rectum on a computer-generated transrectal ultrasound image. In some cases, cancerous lesions may be apparent.

Case closed

The treatment for hematospermia, obviously, depends on the cause. Infection, for example, should be treated with antibiotics. Bleeding in the seminal vesicles, urethra, and prostate can be halted with an electric current. Any systemic problems, such as high blood pressure, should be controlled or treated. And if the amount of blood in the semen is slight, or in cases where there is only one or two episodes of hematospermia, a wait-and-see approach might be best. However, if hematospermia returns, check back with your doctor. Some doctors have found that treating chronic hematospermia with finasteride or dutasteride solves the problem, though no clinical trials have proven the medications to be effective in hematospermia patients. Others may prescribe antibiotics if they suspect asymptomatic prostatitis.

As for my colleague, I am happy to report that he is fine. He had several tests, including a TRUS, but we weren’t able to identify the cause of the bleeding. He did mention that he and his wife hadn’t had sex in quite a while, so the spotting that he saw may well have come from overly full seminal vesicles. Regardless, he hasn’t experienced any more episodes of hematospermia.

While hematospermia can certainly be frightening, it is a benign disorder in most patients. A quick visit with your doctor will probably reassure you that hematospermia is little more than a case of smoke without the fire.

Had first episode heamatospermia during an infection nearly 2 years ago. Had xrays / cystoscopy / ultra sound testicles. Informed that it must have been infection. No problems for 15 months then unfortunately 3 times this year. Approx 3 month gaps. Now stating 2 weeks of antibiotics.

I have had recurring hematospermia for 3 years, am 60 y/o, have seen a urologist and had an MRI and a couple rounds of abx.

The first time I had hematospermia a combination of abx and prostate squeezing (yikes!) indicated infection and resolved it. Later bouts were not due to any apparent infection and the MD essentially said he had no idea.

Now I am having a strong smelling urine for over three weeks and am rushing to my PCP. My question is, do you know any urologists who specialize in hematospermia?

Perhaps I should have gotten another opinion previously, but now I’m alarmed.Thanks very much if you can reply. If not, I understand and again thank you for the information.

I am 35 y/o, experiencing blood clots in semen for the last 4 months n it is continued. I had n Mri ,cystocoy was done ‘ they hv found slight enlargement of left seminal vesicle wid different fluid levels with some calci on prostate. In cystoscopy they found little erosion on prostate .
I was takin cipro then leflox wid max flow but no gain still havin blood clots.
Really worried now.
Doc says it jus coz of inflamation of sem vesicles. They cant do much abt it ‘ But what is the treatment?
Pls help.

I am a 60yo who hasn’t had sex in about 2 years. I have masturbated on occasion, but not anywhere near as often as I would have sex, if I were married. I have suffered a few bouts of hematospermia over the last 6 months – mostly caramel colored semen. Today I had a first time experience with frank blood in the semen. There were discrete spots – large enough to be seen as spots – as large as grains of rice, and very discrete. No sensation of pain. Just the blood.

i am 36 year old male. initially there was blood in urine at start of micturation followed by brown colored semen. i took 2 week course of ciprofloxacin and doxycycline for 1 and half month .there is stil brown color semen and frequency of micturation . plz tell me treatment

Why is there nothing to be found anywhere on the internet about a cure for blood in seman? I have had this problem for 3 years now. I have been thru every test and the urologist says nothing wrong but some calculi in prostate and he cant help me any further. what about massage of transrectal heat rotating magnetic field? An article says it works but then the trail goes dead – cant find anything more. do i just have to live with this the rest of my life until it kills me?

I first noticed my haematospermia in November 2013,at first it was intermittent though more recently has become the norm with discoloration at first ranging from pinkish to brownish red. Its now quite fluidic and watery and comprised only of pre-ejaculate with a complete absence of semen. There is no pain and have had psa test and ultrasound which revealed nothing obvious. Next port of call is a cystoscopy.I’m deeply distressed by both loss of libido and a normal sex life.

I am an 85-yr old male. Recently I have seen a strong whitish ejaculate followed by a slightly weaker light brownish linear discharge. No other symptoms. Urination greatly improved after ejaculation. I have no yet reported this to my family doctor.
Recurrent prostatitis years ago, treated with antibiotics, has not returned.
Otherwise, I have frequent bleeding trouble(gums) possibly related to 3.1 Protime from daily dose of 2.5 mg warfarin prescribed on account of atrial flutter. No flutter symptoms in about 10 years. Minor non-clot stroke experienced months ago. A CABG 4X 12 years ago.
Diagnosed with DDD a few years ago, weight lifting limited.
BP usually under 120/80(systolic sometimes under 90)and HR either about 75 or about 45. Height 5’9″ down from 6,” weight about 160 down about 27 from all time high.

sir please help me for the treatment of my hematospermia.. im 43 years old. and my problem started 3 months ago.. i have a lot of blood in my sperm.but it is not painful.i dont have any blood in my urine only in my sperm.. how to cure this problem please help me.. tnx in advance

Guys. My bout with it was BAD. 99% blood came out when I ejacualted for 6 months. I figured mine out. High intake of red meats. I assume that the uric acids built up way to much and it started crystallizing down there. Lay off the red meats and control your intake of coffee, sugars and dairy. Drink tons of water too. Simple. Rest & heal easy.

I am 50y/o. I had never taken medication in my life untill three weeks ago when I was prescribed a triple dose for ulcers. After the 7 day course i noticed blood in my poo just once. Today I notice my ejaculation is 90% blood. I am scared and i now imagining pain in my pipes

*Hurm*
“BAD?” You wanna know “bad?”
I was 21 when I had my initial episode. I’d spent most of the night in a dorm lobby attempting to woo a woman I was particularly excited about. I went to the men’s room, and found myself unable to urinate except for a trickle of blood. I spent the rest of the night in the infirmary, where they poured as much water down me as possible without my teeth swimming, cleared my colon, and enabled me to find a comfortable position from which I could pass the clots formed from bleeding–well, we never could determine where the source of the bleeding was, but it definitely went into my bladder that night. I spent the next day in the hospital, undergoing a number of inconclusive tests. Eventually, they let me go with a “seems clear now.” After that, I had intermittent hematospermia. *For the next 29 years.* That brings us to *tonight,* boys. We’ve never been able to determine the source–and some docs just told me not to be too concerned. It’s not abnormalities in the prostate; that much I know. Hell, for a while I did work for the local medical schools as a practice patient and underwent rectal exams–I had to be examined at the beginning of the cycle just to be certain that I wasn’t myself an abnormal patient, and I wasn’t.

After nearly three decades of this–on and off–I’ve concluded that my case is probably in the “vascular irregularity” category. It’s most often linked to a particularly turgid erection, and if I sleep on my stomach, I almost always pass a clot the following morning (since most men get an erection in their sleep, I figure I’m no different, and laying on said erection no doubt places extra pressure on it). If there is going to be blood in my semen, I can frequently tell, because my erection feels subtly different–however, this test is not absolute. Numerous times, I thought I would have an episode, but things were all clear.

My approach to it nowadays is relatively simple. I make sure to stay hydrated if sexual activity seems imminent. In addition to hydration being good for you, I’ve come to learn that if there is blood in my semen, I will inevitably have to pass some blood in my urine, and if it has time to clot, better to have more urine behind it than less. I’ve never again had to pass as copious amounts of blood in my urine as I did during that first episode; not by a long sight. After an episode, I’ll normally try to avoid sex for several days or a couple of weeks, but there’s really no rhyme or reason. Sometimes I could have sex within 24 hours and show no symptoms. Other times, two, three weeks later, with no activity in the meantime, and I’ll still show blood. I do not sleep on my stomach.

By the way, I have never had any of the other symptoms mentioned in this article–back pain, weight loss, what have you. Nor am I engaging in frequent, acrobatic, strenuous, or high-impact sexual activity.

The bloody event occurred three days ago to this 87 year-old man. It was the result of masturbation as my 80 year-old wife suffers from severe depression and is not interested in sex anymore but I am. The ejaculate was a steady very bright red. However I noticed just fifteen minutes later that upon urination my urine was crystal clear and has been ever since. Once before at least three year ago I experienced the same event took place and my urologist told me not to worry that it very well probably was a capillary that momentarily burst whithin the system. So I didn’t worry. I might add that this same urologist has me taking the drug flomax to protect my prostate and it seems to be doing a good job as all recent tests have revealed only a small enlargement in the organ. I have not sought a doctor’s opinion for this latest occurrence and don’t intend to unless the next ejaculation is a repeat. I don’t think it will be.

thank you for this very informative article, also to user eric. lately i’v bin gaining wait and i drink a lot of 3in1 coffee to be specific and yes sometimes i feel dizzy which makes me think i have a high blood pressure problem. i started noticing my hematospermia last 2012 while masturbating. panicked, i rush to see a GP and gave me sum antibiotics, and honestly i did not believe her, i surf the internet instead, luckily i found answers like this article did. after 2weeks of abstinence blood is gone. then this august 2014 after having sex with my gf i see a lot of blood again. worried so i surf the net again and found this. and what eric said might also apply to me. i hve no other symptoms aside from the blood.

been dealing with this on and off, for the past 4 years.
Never once has there been blood during masturbation. Ever!!!
However it is now to the point that regular intercourse will result in bloody semen. Which very very quickly clots up.
I have to be basically full of water prior to intercourse. Then immediately go pee ASAP, after intercourse. If not it will clot up. Very painful to pass several clots. Sometimes taking the whole day. I once had to go to the emergency dept to have a catheter inserted to relieve the pressure followed by passing of clots.
I have not had any injuries or accidents, good PSA results, regular prostate exams, biopsy samples taken of my prostate ( extremely painful ) and no cancerous tissues.
My urologist is not concerned, but this is very taxing.

I for the last three weeks have been passing blood on ejaculation, it started as spotting, then watery blood, its now 90% blood. I have been to the doctors, he gave me finger up the arse treatment, tested blood pressure, urine test for blood which was clear. i’m 55 and type 2 diabetic he sent me to see a specialist at the hospital who gave me the anal finger treatment again where he confidently stated I have an enlarged prostate and he believes a condition called Prostatitis. he has given me a 28 day course of antibiotics which I prey works. just had sex with my wife, not intercourse but she gave me a hand job and the condition is the same, all blood. Very scary, just got to wait and see what happens after tablets finished. going private if it does not work with tablets…. I am very worried as is the wife, looked into prostatitis and its says everywhere its very painful, well, I have had no pain so I have concern over diagnosis, they either don’t no what’s up or they like fingering peoples arse holes, my advice is get as many opinions as you can and don’t sit about listening to so called experts, keep moving forward at all times making as much noise as possible.. after all they are not the ones with the worries and the blood coming out of their dicks,,, do your doctors head in at all times that’s what we pay for in out tax and health stamps after all.

I’m 84. I note here that guys some years older have reasonably successful orgasms. I had a fifteen year period of total sexual abstinence for religious reasons when I was younger, which I now regret. My first masturbation after that produced a gelatinous brown semen which scared the hell out of me. Since then I’ve had BPH and was on Finasteride for about 25 years. About 5 years ago, as males in my family develop prostate cancer, despite frequent visits to my Eurologist I was diagnosed with a Gleason in the low seven range. Mind you I had a GP and a Eurologist tell me after a cystocopy that I was cancer free and the GP said the blood was probably a crystal in my eurethra. Subsquently, after hormonal treatment at Sloane and radiation, I’ve been okay but now my BPH is increasing (or is cancer coming back?) Recently a bone and cat scan showed “enlargement of the prostate” Is BPH common after all that treatment? Last night an attempt at masturbation resulted in no orgasm and no ejaculation. After struggling to hit the spot, I just gave up. Went to Yoga. Astanga. This morning two pink spots show on my sheets and a trial of my first drops of urine on a white napkin showed pink. My next urination was clear. Hoping its simple BPH and not an increase in cancer. Have an appt. with my radiologist in 2 weeks and will talk about all of it. I need to know if if a return of cancer would show up in recent cat and bone scans I had. At Sloane, a nurse reading the results and my GP say “all seems clear” but your prostate, though not as large as it was before treatment, is now getting larger.” The other question is: Is it really only more BPH which i’ve had since thirty y.o. or… is the cancer coming back? If not cancer, is there any remedy besides my one FLOMAX one half hour after dinner. Just one makes me dizzy in Yoga or do I have to bite the bullet and now take two a day or go back to finasteride? I had the green light about nine years ago, before the cancer diagnosis; , but now the old prostate is growing. If just more BPH can the green light be done a second time. Also are there other measures for BPH considering my medical history? Please don’t let the answer be more cancer, more hormonal shots and more radiation. I had forgotten I had those problems and I’m still working long hours a day at what I do. Thanks men.

We’re a group of volunteers and opening a new scheme in our community.
Your website offered us with valuable info to work on. You’ve done an impressive job and our whole community will be grateful to you.

Can you please refer me to the doctor who wrote this article, I would like to make an appointment to see him because my life is really depressing with this situation and my doctor didn’t seem intrested in solving it. Thank you

Thanks for this valuable information.I have had some blood in my semen. I had a PSA, ultrasound and a rectal test..Everything is ok..Since then my life style has changed a lot..I have to be more concern about my health and diet because I’m already 60 and my wife 35 jaja..Now I know I can do things to have a better life and health..I suggest that with the first alarm we have to see a doctor immediately..Thanks a lot Doctor,your opinion is worth a fortune..

I am 50 years old. I have had blood in semen for over 2 years. Sometimes even an erotic dream (without ejaculating) leads to blood in urine. Few brief periods were it stopped for a short time. I also get clots in my urine after ejaculation, and sometimes it is so difficult to poss that I must wait until the following day to develope enough pressure to get the urine out. Often when urine does finally come out, it’s extremely messy because of spray from the pressure buildup. It’s awful. Never mind the uncomfortably of bloody seamen with your partner, blood on sheets…
I have had every test done except for MRI. told by two different urologists, nothing they can do. Hard to believe there is nothing that can help.

There is a big link between zinc deficiency and hematospermia . Take zinc supplements daily . Every situation is different but in a lot of cases this is the magic pill and you may see a noticeable improvement / absence within a month .

No Evidence for zinc whatsoever or selenium or Vitamin E!
The SELECT trial was a randomized controlled study designed to evaluate vitamin E, selenium, and the two in combination in the prevention of prostate cancer. Unfortunately, this study failed to show a benefit from either supplement. Many people were critical of the choice of vitamin E and selenium; these agents were chosen because they had been used in the studies that formed the basis for the SELECT trial.

Now, an update of this study has shown that these agents actually harmed some men. Men with high levels of toenail selenium upon entering the study and who were randomly assigned to receive selenium (either with or without vitamin E) had a 91% increase in high-grade prostate cancer. In addition, men with low selenium levels who received vitamin E alone had a significantly increased risk for total, low-grade, and high-grade prostate cancer.

These findings have two important implications. First, the public needs to recognize that it is false to assume herbs, vitamins, and supplements cannot cause harm. Second, this study again illustrates the importance of properly testing supplements in randomized trials rather than making conclusions from epidemiologic or uncontrolled case studies.
Caveat Emptor

I had a cystoscopy in Oct. 2013. Three weeks later my ejaculate was bright green with threads of blood. Doctor told me it was “normal” and would go away. By December 2013 I was ejaculating blood. I have had back to back months with strong antibiotics in the Spring of 2014. MRI, Ultrasound and another cystoscopy (different doctor) and can’t find the problem. At this point the question isn’t “blood in the ejaculate”, its is there any semen in the blood. At wits end, need to find a specialist who can fix this.

Glad I am not alone in this…. and do need to get it checked out, just in case. That being said, I’ve been living with it for 14 years now… just turned 41…it’s an on again off again thing with me.. no rhyme or reason to it. Luckily there is no pain, just an “odd” feeling before ejaculating, and the sometimes very large clot to pee out after. Unfortunately, when it happens it’s like really blood red, not brown or yellow or lumps..just blood. Can barely tell it’s semen. SO unsettling and annoying. I’m single and have to try to explain this before sex…. how the hell do you explain this to a person you haven’t slept with yet?? Not exactly a turn-on. As if dating isn’t hard enough already. So just wanted to add my two cents that we are out there and are dealing with it too…you aren’t alone. I really need to look into treatment options…at least they are out there now. When I first investigated it in 2000 there seemed like no treatment… it was just the “live with it” diagnosis. This Blog gives me hope that someday (soon?), there can be an end to this. Thanks for posting.

Guys I found a correlation between. Red meat consumption and this issue. Consuming large amounts of fatty red meat as causes it (for me) and being dehydrated or taking stuff like caffeine (coffee) which can dehydrate you intensifies the issue. Euric acid must be accumulating in that region.

Eating only poultry and fish, drinking lots of water seems to resolve things for me. Sucks because I love hamburgers.

I’ve had chronic haematuria for 12 months now. It’s been constant with every ejaculate and blood red so it looks fresh. Basically my semen just looks like blood! Pretty scary and worrying. I’ve had PSA, MRI, cystoscope, bacterial cultures, antibiotics and finasteride and nothing has been found or worked. I’ve been told I now have to live with this, but I can’t help worrying, something is not right. Any advice for where to next?

It appears that when this occurs the medical establishment does not seem too concerned, but to those of us that experience this it is extremely troubling…I have experienced blood in semen for three years…it first started as slight discoloration then progressed to a full stream of blood… now it comes and goes in various amounts of blood…many exams and tests conclude no physical reason for the occurrence…I am 58 years old in excellent health and take no medications for any conditions…I do recall that before this ever happens I did take an erectile drug and soon thereafter this condition started but no doctor has indicated this was the cause of the problem..I can get erections regularly and masterbate often and have noticed that even when little of no blood is present my semen is not near in consistency and thickness that I had in my younger days…I am assuming that as I age my semen was suppose to get thin and watery not thick and creamy like it used to be…sure wish there was a way to talk about this with others

I am 64 and I have been seeing blood in my Semen constantly over the past seven years so far. It started in the first two years as brown clots but, in the following five years or so, I see my semen ejaculation starting normal then, towards the end of the ejaculation, the last few drops of ejaculate are reddish (almost pure fresh blood). I tried both abstaining and having more sex but the blood persisted. Two years ago, I have two PSA tests at 5 but also I had two normal prostate digital exams. Ultrasound shows that my prostate is very much enlarged. However, my urine stream intensity fluctuates. It is frequently weak but it gushes and reaches maximum flow immediately after sex. In fact, after sex, I can urinate so vigorously just as when I was so young and more healthy at 20. Therefore, as a layman, I reasoned that if I had prostate tumor, the urine flow rate (intensity) should not fluctuate because a tumor is expected to cause permanent restriction to urine flow. This is why I am reluctant to do prostate biopsy just because my PSA is 5, especially given the fact (according to research) my enlarged prostate condition itself can also be the reason for this high my high PSA. In addition, biopsies are inaccurate and, hence, inconclusive. So, I am living with this “blood in Semen” condition and intend to do NOTHING about it! Who knows, it might still go away by itself after all, but I refuse to plunge in inconclusive diagnostics which can do more harm than good!

Never had any blood in my semen but was diagnosed years ago with micro hematuria, tiny tiny amounts of blood in the urine. All testing was inconclusive. Probably still have it.

The other day my female friend went overboard and I wound up with blood in my semen, I mean bright red!! Urinated about 15 minutes later and all was fine. Have been urinating for two days with no issues. Feeling that I needed to know I masturbated and small amounts of blood was in the semen. Anyone have this happen from aggressive oral sex??

I’ve had this for the first time twice lately in my 40 years. Can’t say exactly what caused it and what is causing it for you people out there and in fact there could be combined factors causing this both for you and myself. However in my case, after first submitting samples of my sperm to my urologist, it was found on both cases that I had bacteria in it(source of which being either shit or tooth cavity). So the likelihood of this bacteria causing the bleeding as a result of inflammation of the prostate or seminal vesicle seems the likely source of blood in my semen (red color) and either blood or bacteria or white blood cells in the semen (brownish color). However these may be secondary factors, hard to say, and I have still yet to have my sperm tested (by PCR) for Ureaplasma, mycoplasma or fungi. Haven’t ruled out to much cycling either as being the cause. Some doctors and specialists argue that having bacteria in our semen is not the cause of Prostatitis or hematospermia but if it is, I would advice you all to get blow jobs with condoms as I probably acquired this bacteria from those sources. So first thing you need to do is to give a semen sample when your body has been free of antibios for at least three weeks, stop cycling, you also you need to ejaculate frequently to stop any buildup of semen and bacteria. I was also put on a course of tablets that got my blood flowing there as my doctor said it may be caused by a congestion of blood there. Also said I need to sit less and exercise more (walk)On both cases he cured it for me. I’m going to have to stay away from women for a while though to see if they really are the cause of this. Good luck, we are all suffering with this b(tch.

I’m 54 and have had problems since 49 when l was admitted to emergency dept. with AUR. Have had catheter in and out with increasing frequency and has been in now for almost 18 months! Have had blood in ejaculate for last couple of years and a recent biopsy detected cancer, but it is very small. My urologist is more concerned about getting the catheter out of me. Like everyone else here l was freaked out about blood in ejaculate but urologists couldn’t tell me why, but I have noticed a pattern. I usually get blood after eating and drinking badly particularly beer, red wine and coffee as well as fatty food. My PSA went from 5.6 in 2009 to 31 in late 2013 which scared me so much l gave up alcohol. By the time of my next PSA it had fallen to 15, and with healthy eating and supplements it is now 10.5, so diet plays a big part Also l have had chronic constipation and IBS for a least a decade. I have read a few books on the subject and scanned many weblogs. My theory is the prostate sits very close to the sigmoid colon. If you have shit (toxic sludge) sitting close to the prostate for any length of time, its no wonder the prostate swells. The bleeding is probably due to stones or crystals formed by the body as an emergency measure to deal with the toxic sludge. Also the pressure of shitting causes it to bleed. Anyone with prostate problems must read The Natural Prostate Cure by Roger Mason. Avoid crippling surgery and a painful death and improve your diet. Meat and dairy foods with high fat levels are the cause of prostate cancer. Milk has 35 hormones that stimulate cancer growth, Professor Jane Plant in the U.K. has written 2 excellent books on prostate and breast cancer which are related. Professor Plant put her breast cancer into remission in the early 80s by giving up meat and dairy, check it out.

Hey, 54 year old gay male here who has had 6-8 episodes of bloody ejaculate over the past three years. I’ve always been able to link these episodes to some pretty aggressive BJs that I’ve received or aggressive pounding as I top. Also, I always feel a sort of ‘ripping’ or ‘tearing’ sensation, just for a second, right before ejaculating. However, the blood stops almost immediately afterwards. Nevertheless, it’s always disturbing and this last time has sent me back to the internet. I’ve made an appt with a urologist, but now I’m thinking of canceling it — I’m totally without symptoms for months between these episodes, and perhaps I can deal with it by being a little more careful and less aggressive in sex. Still, just wanted to share this here, as I found this blog comforting.

I have had this off and on for about 10 years. It comes and goes and varies in how much blood is there. I was diagnosed with a mulerian duct cyst. I had it drained once, which was not much fun. The specialist I saw afterwards basically said masturbate/have sex more and it will go away. Which to be fair, it does. Recently had a flare up and its the bloodiest it’s been before and since I’m now approaching 40 I’ll go and get it checked out again.

Hi, 23 year old male here. First noticed blood in my semen around two weeks ago. Masturbated every day since to check daily, id say 95% of all times there is blood, some very bloody, some only a little. I had blood tests done a few months ago and blood pressure was high. What do I do? kind of scared to go to the doctor but guess I need to man up.

i am a 64 year old man and have blood in my seaman but no blood in my urine i am taking Ciprofloxacin film coated Tablets i also take at the same time Codiene for back pain Fexofenadine Tabiets for Hayfever and Ibprfen also re back pain my penis is some times red at the tip and my TESTICLES seem a little sore but no pain 19 years ago i had a Vesectomy could this be part of the problem?

This blog aims to provide reliable information as well as healthy dialog about the topics covered. We reserve the right to remove comments for any reason, particularly those that do not relate directly to the contents of this post, are commercial in nature, contain objectionable or inappropriate material, or otherwise violate our Privacy Policy. Comments on this blog do not represent the views of our editors or Harvard University, and have not been checked for accuracy. All comments submitted to this site become the non-exclusive property of Harvard University.